Which of the following in NOT a feature of adult polycystic disease:

Correct Answer: B

Rationale: Adult polycystic kidney disease (ADPKD) is familial, bilateral, asymptomatic until adulthood, and presents with hematuria/hypertension unilateral involvement is rare. This distinguishes ADPKD's bilateral nature, critical for genetics, contrasting with unilateral misconceptions.

Correct Answer: D

Rationale: Renin rises with hypovolemia, DCT hyponatremia (macula densa), and sympathetic input not PCT (no sensing role). This distinguishes renin triggers, vital for blood pressure regulation, contrasting with tubular mislocation.

Correct Answer: B

Rationale: Struvite (magnesium ammonium phosphate) crystals appear rectangular (coffin-lid shape) under microscopy classic infection stone marker (e.g., urease bacteria). Needle-shaped fits urate or cystine wrong chemistry. Amorphous lacks distinct form, unlike struvite's structure too vague. Hourglass isn't typical confuses with other forms. Rectangular morphology distinguishes struvite, key to identifying infection-driven stones, unlike sharp, shapeless, or misattributed shapes.

Correct Answer: D

Rationale: Optimal surgery for GUTB is 4-6 weeks post-therapy, not 1 week allows inflammation reduction, incorrect timing. GUTB is second to pulmonary in developing areas true prevalence. Kidney involvement is ~80% primary site. Urine AFB culture is gold standard specific diagnosis. Delayed surgery distinguishes correct management, key to balancing medical and surgical needs, unlike true epidemiology or diagnostics.

Correct Answer: C

Rationale: Columns of Bertin are cortical extensions between medullary pyramids structural dividers, not medullary. Pyramid apex is papillary urine exit. Medullary extensions are pyramids themselves wrong tissue. Conical areas are pyramids, not columns shape error. Cortical columns distinguish them, key to renal architecture, unlike medullary or conical misplacements.